Requesting a Refund

If you need to request a refund, please follow these instructions carefully in order to ensure we receive your completed Employer Refund Request form.

  • Complete the form.
  • Submit the form using one of two options:
    • Print and fax the form to Business Solutions at (916) 636-2436.
    • Submit the form electronically by selecting the "Submit" button at the bottom of your completed form. When you click "Submit," you will need to select which email source you would like to use. Then, the document will automatically appear in an e-mail as attachment. Click send in the email and you will receive an automatic reply by e-mail confirming receipt.
      Note: If you do not receive this confirmation, then you may be experiencing some technical difficulties.
      Your completed form has not been sent. You will need to print and send it by fax, as described in option "a," above.
  • Employer Refund Request Form
    To submit the form online, you must have the latest version of Adobe's Acrobat Reader. Download it for free.